Elliot Victoria, Yaskina Maryna, Schulz Jane
From the Department of Obstetrics and Gynecology, Faculty of Medicine & Dentistry.
Women's & Children's Health Research Institute, and.
Female Pelvic Med Reconstr Surg. 2019 Mar/Apr;25(2):109-112. doi: 10.1097/SPV.0000000000000684.
An estimated 4% to 6.6% of women delivering vaginally sustain obstetrical anal sphincter injuries (OASI). Despite this, a gap exists in the provision of postpartum care to women globally. Given the negative impact of OASI, action is needed, and multidisciplinary perineal clinics can help. Consequently, such a clinic was established in 2011 at the Royal Alexandra Hospital (RAH), a tertiary care center in Edmonton, Alberta.
This study assesses the state of perineal clinics specializing in OASI internationally and locally by investigating the literature for descriptions of specialized perineal clinics for women with OASI, describing the RAH perineal clinic, and assessing the prevalence of OASI at the RAH in the context of the clinic.
A search of peer-reviewed literature was conducted on Medline and observations and interviews of RAH perineal clinic staff were conducted, as was a medical chart review.
Articles describing only 10 perineal clinics specializing in OASI were found, with varying structures. The multidisciplinary RAH clinic, like one other clinic, has a strong physiotherapy focus, with education and Pilates classes and one-on-one appointments offered by pelvic floor physiotherapists. In 2016, of the 326 (6.9%) vaginal deliveries that resulted in OASI at the RAH, only 66.0% (215) were referred to the clinic.
Multidisciplinary perineal clinics are needed globally. Despite the creation of the perineal clinic at the RAH, women continue to lack specialized care after OASI. It is crucial that healthcare professionals specializing in OASI share their experiences to establish best practices and create new, and improve existing, perineal clinics.
据估计，经阴道分娩的女性中有4%至6.6%会发生产科肛门括约肌损伤（OASI）。尽管如此，全球在为这些女性提供产后护理方面仍存在差距。鉴于OASI的负面影响，需要采取行动，多学科会阴诊所可能会有所帮助。因此，2011年在位于艾伯塔省埃德蒙顿的三级护理中心皇家亚历山德拉医院（RAH）设立了这样一家诊所。
本研究通过调查关于OASI女性专科会阴诊所的文献描述、介绍RAH会阴诊所，并在诊所背景下评估RAH的OASI患病率，来评估国际和本地专门针对OASI的会阴诊所的状况。
在Medline上检索同行评审文献，并对RAH会阴诊所工作人员进行观察和访谈，同时进行病历审查。
仅发现10篇描述专门针对OASI的会阴诊所的文章，这些诊所结构各异。多学科的RAH诊所与另一家诊所一样，非常注重物理治疗，提供教育课程和普拉提课程，并有盆底物理治疗师提供一对一预约服务。2016年，在RAH导致OASI的326例（6.9%）阴道分娩中，只有66.0%（215例）被转诊至该诊所。
全球都需要多学科会阴诊所。尽管RAH设立了会阴诊所，但OASI女性仍缺乏专科护理。专门研究OASI的医疗保健专业人员分享他们的经验以建立最佳实践，并创建新的和改进现有的会阴诊所至关重要。
